Turns out it's not as easy as Batman makes it look.

Tag Archives: health care

Admit it. Some time in your life, you’ve probably taken a Harry Potter sorting quiz, typically from the Internet, as I just did yesterday. Supposedly, I’m a Hufflepuff, but one of the hypotheticals this quiz used to make that determination stood out to me:

“You have saved up for months to buy a new bike. As you’re getting ready to buy it, a child runs by and steals your money. You chase him down and find that his mother is deathly ill and the child stole the money to buy her medicine.”
— The Almighty Guru

Granted, this dilemma is not particularly deep, and it’s at least as old as Les Miserables, but even my cynical self can acknowledge the value of asking the simple questions. This scenario frames the matter in a different light than that book, as the thief is a child, whose mother’s sickness is directly emphasized.

None of which makes the problem any easier. The compassionate thing to do obviously seems to be to let the kid keep the money, considering America’s health care system does not — as far as I know — guarantee a safety net of basic life-saving care for someone who cannot pay for it. How, after all, does the value of a bicycle compare to that of a person’s life, especially when that person is loved dearly by a child?

Put that way, it looks simple. Any other course of action would be callous by comparison. Yet how can we say this consistently when our priorities, in so many ways we like to pretend don’t exist, claim otherwise?

Our society allows grotesque numbers of preventable deaths — in this country alone — because people don’t have the money that we spend on extravagant dinners and extra TVs. We consider it theft for a government (as for one person) to use taxation to combat this solipsism.

We unquestioningly make automobile transportation the social norm, and many of us criticize capital punishment for being a cruel institution of denial of life’s value. This is despite, as the speaker in the video below notes (skip to about 4:35), the damage several orders of magnitude greater inflicted by car accidents compared to the death penalty.

The uploader’s numbers vary somewhat from the source above (even considering the video was made in 2011), but his point stands independent of the particular ethical question he addresses here — which I may return to in future posts, particularly referencing the central argument of this video. I encourage the reader to watch it in full regardless, since if nothing else it’s a case study in the subtle complexities of moral arguments that appear straightforward, one way or the other.

DISCLAIMER: None of this is to say that the above attitudes are necessarily unacceptable (or, if they are, they may be brute facts of apathetic human nature we have to accept), as I am of course oversimplifying things. (Or am I? Is this what every generation that permits appalling social evils tells itself, just as we said centuries ago that slavery was too integral to the South’s economy to abolish?) It could be that the true error lies in our moral hypocrisy, or that the value outweighing the proverbial mother’s life is a fundamental liberty, although I like to think the obvious answer to this dilemma really is the right one. It wouldn’t be easy to live up to, but it would leave us less demoralized and more confident in our consciences.

I’m not trying to be wishy-washy. I just think some perspective on issues like this couldn’t hurt, and if the idea I imply here does turn out faulty upon further inspection, so much the stronger does the truth stand after this test. Undoubtedly, this consideration will help us as we continue looking at John Locke’s work.

“We sentence people to incarceration. We do not sentence them to untreated medical conditions. We don’t sentence them to untreated gender dysphoria just as we don’t sentence them to untreated kidney failure, untreated infections, or anything else of the sort. When the government takes on inmates and incarcerates them, it becomes responsible for their medical care. And this condition from a medical and scientific perspective is no different from any other medical condition that requires treatment. And increasingly from a legal perspective as well. Civilian courts have found in almost all cases that prisons are required to provide hormone therapy and increasingly surgery as well. Not to do so is considered cruel and unusual punishment under the Eighth Amendment.”
— Lauren McNamara, an activist and friend of, and former defense witness for, Chelsea Manning, explaining why hormone therapy is a medical necessity for trans people and why Chelsea ought to be treated in prison

The third perspective to which I alluded on Saturday (quite honestly, this was a busy week for me, so there’s why it took me so long to update) is the one McNamara speaks of in the above quote. Having fact-checked her on this, I found in an extensive source referenced in Part II ample evidence to suggest not only that gender dysphoria is responsible for considerable struggles in the lives of many individuals, but also that the most effective treatment is transitioning. While the extent to which any given trans person would be best off transitioning varies, common elements of this process include hormone replacement therapy, SRS, and — most critically — integration into the authentic gender identity in a way that maximizes comfort with the self. As far as none of this causes unethical harm to the transitioning person or to others, the need for acceptance of trans people and demolishing of the myths surrounding transgender issues is undeniable.

Where, then, does this leave Private Manning? Currently, the prison in which Manning resides offers no more than psychiatric assistance for gender dysphoria as part of inmate health care. This may sound reasonable enough on paper, but the problems are twofold. First, as noted in the aforementioned source, the sort of therapy that is standard practice for military inmates is not nearly as effective as the remedies prescribed almost unanimously by psychological journals (e.g. the AJP). The former methods, which tend to focus more on eliminating the desire for elements not conforming to the norms of the birth sex (analogous to ineffective “pray away the gay” tactics), are as relatively inefficient as if we treated PTSD with Freudian psychoanalysis.

Second, these facts lead inevitably to the conclusion McNamara reaches: that the government has no more right to deny trans people any necessary treatment than it does to preclude mental health care for sufferers of depression. For many, as is medically demonstrated, dysphoria manifests as a form of depression and should be treated as such in urgency.

Why, many ask, should the people’s tax dollars go toward funding this treatment for a person at least a fair deal of the country considers a traitor? For the same reason taxes go toward any other sort of prisoner medical care: inmates are not legally allowed to pursue their own private health care, thus, as the system currently runs, they can only rely on the government’s provisions of such services. The alternative is to add unnecessary physical and mental suffering to the sentence, which is indeed “cruel and unusual punishment under the Eighth Amendment.” Those who take issue with this policy are doing just that; it has nothing to do with the rights of trans inmates specifically.

To close this post, consider this graphic:

In far too many — not all, but enough for us to care — cases, a lack of acceptance of trans people wreaks damage on multiple levels. Families are broken, jobs are lost or precluded to begin with, discrimination is imposed at every turn, physical and sexual abuse is endured, and lives come to tragic ends. This is a real problem, and it is not inevitable. The vast majority of that which plagues the trans community begins in the attitudes, speech, and actions of you and me. For those who are denied respect solely on the basis of their gender identities, in honor of Suicide Awareness Week, we ought to do better. Manning was once one of the youth described above, and her case brings light to the need for a paradigm shift in our overwhelmingly cissexist society.